Identification, Coding, and Reimbursement of Pediatric Malnutrition at an Urban Academic Medical Center

Autor: Yimin Chen, Sarah J. Peterson, Sabrina M. Bierman
Rok vydání: 2018
Předmět:
Male
0301 basic medicine
Parenteral Nutrition
medicine.medical_specialty
Consensus
Dietetics
Nutritional Status
Medicine (miscellaneous)
Documentation
Child Nutrition Disorders
03 medical and health sciences
Enteral Nutrition
0302 clinical medicine
International Classification of Diseases
Prevalence
medicine
Electronic Health Records
Humans
Nutritionists
Hospital Costs
Child
Diagnosis-Related Groups
Reimbursement
Retrospective Studies
Academic Medical Centers
030109 nutrition & dietetics
Nutrition and Dietetics
Financial impact
business.industry
Medical record
Malnutrition
Clinical Coding
Secondary diagnosis
medicine.disease
Hospitalization
Parenteral nutrition
Family medicine
Insurance
Health
Reimbursement
Registered dietitian
Female
030211 gastroenterology & hepatology
Societies
business
Coding (social sciences)
Zdroj: Nutrition in Clinical Practice. 33:640-646
ISSN: 0884-5336
DOI: 10.1002/ncp.10064
Popis: Background The American Academy of Nutrition and Dietetics and the American Society of Parenteral and Enteral Nutrition released a pediatric malnutrition consensus statement in 2014 recommending the use of z-scores as indicators for identification and documentation of malnutrition. A shift in focus is needed on standardizing pediatric malnutrition language at institutions nationwide to make study data comparable. With this standardized language, establishment of institutional baselines for identification, coding, and reimbursement of pediatric malnutrition is crucial to measure process improvements. Objectives The objectives of this study were to determine the prevalence of malnutrition among pediatric patients at an urban academic medical center, the frequency of malnutrition codes used, and the reimbursement impact of coding for malnutrition. Methods Electronic medical records of pediatric patients admitted from January 2013 to December 2015 were reviewed. Malnutrition was identified based on registered dietitian identification and z-score. Patients given a malnutrition-related International Classification of Diseases code upon discharge were identified. A reimbursement calculation was performed: the malnutrition-related International Classification of Diseases code was removed to determine the difference in reimbursement with vs without the code. Results Of the 1,532 admissions included in this study, 464 (30%) were identified as malnourished. A total of 152 (33%) malnourished patients were given a malnutrition-related secondary diagnosis. The calculation revealed that coding for malnutrition resulted in an additional $27,665.70 to the medical center. Conclusion Malnutrition coding may have a significant financial impact and processes improvement efforts can be made to improve malnutrition coding.
Databáze: OpenAIRE
Externí odkaz: